Citation NR: 9735296
Decision Date: 10/20/97 Archive Date: 10/24/97
DOCKET NO. 96-31 998 ) DATE
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On appeal from the
Department of Veterans Affairs Regional Office in St. Louis,
Missouri
THE ISSUE
Entitlement to a restoration of a 30 percent rating for
glomerulonephritis with hypertension, currently evaluated as
noncompensably disabling.
REPRESENTATION
Appellant represented by: AMVETS
WITNESS AT HEARING ON APPEAL
Appellant
ATTORNEY FOR THE BOARD
Carole R. Kammel, Associate Counsel
INTRODUCTION
The veteran served on active duty from May 1986 to September
1991.
This matter comes before the Board of Veterans’ Appeals
(Board) on appeal from a March 1996 rating decision of the
Department of Veterans Affairs (VA) Regional Office (RO) in
St. Louis, Missouri, which reduced the disability rating for
glomerulonephritis with hypertension from 30 percent to
noncompensably disabling.
REMAND
The veteran and his representative contend that his
disability rating should not have been reduced because his
condition had not improved. The veteran alleges that he has
back pain, hematuria and swelling of the limbs as a result of
his disability.
In addition, the Board notes that the veteran was previously
examined by VA in December 1995. At that time of the
examination, however, the examiner indicated that the
veteran’s claims file, including previous medical
examinations, was not available for review. The United
States Court of Veterans Appeals has held that a medical
examination must consider the records of prior medical
examinations and treatment in order to assure a fully
informed examination. Caffrey v. Brown, 6 Vet. App. 377, 381
(1994) (citing Waddell v. Brown, 5 Vet. App. 454 (1993)).
Therefore, in light of the foregoing, the Board is of the
opinion that an additional examination is necessary in order
to determine the current severity of the veteran’s service-
connected glomerulonephritis with hypertension.
Accordingly, this case is REMANDED to the RO for the
following action:
1. The RO should contact the veteran and
request that he identify specific names,
addresses, and approximate dates of
treatment for all health care providers,
private and VA, from whom he has received
treatment since December 1995 for his
service-connected glomerulonephritis with
hypertension. When the requested
information and any necessary
authorization have been received, the RO
should attempt to obtain copies of all
pertinent records which have not already
been obtained.
2. Thereafter, the veteran should be
afforded a VA general medical examination
by a Board certified physician in order
to determine the current severity of the
service-connected glomerulonephritis with
hypertension. Any special diagnostic
tests, including blood pressure readings
and any necessary lab reports should be
performed. The examiner must review the
claims folder prior to the examination,
with specific attention to the December
1995 VA examination report. The examiner
must specifically identify whether there
is any objective evidence of any constant
or recurring albumin with hyaline and
granular casts or red blood cells or
transient or slight edema or hypertension
at least 10 percent disabling under
Diagnostic Code 7101 (i.e. diastolic
pressure of 100 or more) found on
examination. A complete rationale for
all opinions expressed must be provided.
3. The RO should then review the report
pertaining to the VA examination
performed in response to the previous
directive to ascertain whether it is in
compliance with the Board’s examination
instructions. Corrective action should
be under taken if less than full
compliance is found.
4. Then, after undertaking any
development deemed necessary in addition
to that specified above, the RO should
readjudicate the issue on appeal.
If the benefit sought on appeal is not granted to the
satisfaction of the veteran, the veteran and his
representative should be furnished with a Supplemental
Statement of the Case on the issue in appellate status.
Thereafter, the case should be returned to the Board for
further consideration, if otherwise in order. By this
REMAND, the Board intimates no opinion as to any final
outcome warranted. No action is required of the veteran
until he is otherwise notified by the RO.
F. JUDGE FLOWERS
Member, Board of Veterans' Appeals
Under 38 U.S.C.A. § 7252 (West 1991), only a decision of the
Board of Veterans' Appeals is appealable to the United States
Court of Veterans Appeals. This remand is in the nature of a
preliminary order and does not constitute a decision of the
Board on the merits of your appeal. 38 C.F.R. § 20.1100(b)
(1996).
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